There is so much written and discussed in health and council circles about the importance of integrated health and care systems. Sometimes it feels as if just the act of bringing these systems together in unified governance structures means services will automatically be better.

The NHS talks about ‘patients’. Sometimes they are referred to as ‘the deteriorating patient’, sometimes ‘the stranded patient’ or even worse ‘the super-stranded patient’. We have competing clinical commissioning groups and hospital trusts desperately trying to stay on target and repatriating people who have ended up in the wrong hospital. The targets can drive some bizarre behaviours.